This was a vote on passage of a bill making major changes to the national health care system. House passage of the legislation – which had already passed the Senate -- would clear the bill for the president's signature.

The Senate-passed bill imposed a requirement that most Americans have health insurance, added 15 million people to the Medicaid rolls, provided funding to subsidize the purchase of private health insurance coverage for low- and middle-income people, and prohibited insurance companies from refusing coverage because of “pre-existing conditions.” The bill would also place a 40% tax on high-cost insurance plans -- or those plans that are worth more than $27,500 for families, and $10,200 for individuals.

Under the legislation, insurers would be required to cover preventive care -- such as regular checkups -- at no cost to customers. The bill was estimated to cover 31 million uninsured individuals. Under the bill, an estimated 95% of Americans would have health insurance.

Immediately following the vote on the Senate-passed health care bill, the House planned to bring up a second health measure. The second bill made a number of changes to the Senate legislation, including delaying the implementation of the tax on high-cost insurance plans until 2018. It also expanded coverage to 32 million people, one million more than the Senate-passed bill. The second bill was brought up by Democratic leaders under a process known as budget reconciliation. This process shielded the bill from a filibuster in the Senate, allowing it to pass that chamber with a simple 51-vote majority.

House Majority Leader Steny Hoyer (D-MD) argued the bill represented "the end of discrimination against Americans with preexisting conditions, and the end of medical bankruptcy and caps on benefits. It is coverage you can rely on whether you lose your job or become your own boss, coverage that reaches 95 percent of all Americans….Illness and infirmity are universal, and we are stronger against them together than we are alone. Our bodies may fail us; our neighbors don't have to. In that shared strength is our Nation's strength, and in this bill is a prosperous and more just future."

Rep. Henry Waxman (D-CA), the chairman of one of the committees that drafted the legislation, said: "This bill provides all Americans the security of knowing they will always be able to afford health care for themselves and their families. The bedrock foundation of the legislation is that it builds on what works today and reforms what doesn't, but we fundamentally reform the insurance company practices that are failing our families."

Rep. Ed Markey (D-MA) criticized the Republicans for seeking to delay and obstruct passage of the legislation: "GOP used to stand for Grand Old Party. Now, it stands for grandstand, oppose, and postpone. They grandstand with phony claims about nonexistent government takeovers, they oppose any real reform, and then they want to postpone fixing a broken health care system. GOP: Grandstand, oppose, and postpone."

Republicans denounced the bill as a "government takeover" of health care that would lead to economic ruin: Rep. John Shadegg (R-AZ) said: "Tragically, this bill will destroy freedom and do incredible damage to the very fabric of our society. This bill is a bailout for the insurance companies. They get the individual mandate that they wanted all along--a mandate that is un-American and unconstitutional."

Rep. Joe Pitts (R-PA) argued the bill would use taxpayer dollars for abortions: "This bill violates the conscience of the American people….This extreme legislation is being forced on an unwilling Nation. It is the most pro-abortion bill and the largest expansion of abortion in our history. No Member who votes for it will ever be able to claim again that they have always stood on the side of the unborn."

Rep. Devin Nunes (R-CA) argued the bill would lead to socialism and totalitarianism: "…This debate is not about the uninsured; it's about socialized medicine. Today we are turning back the clock. For most of the 20th century, people fled the ghosts of communist dictators, and now you are bringing the ghosts back into this Chamber. With passage of this bill, they will haunt Americans for generations. Your multitrillion dollar health care bill continues the Soviets' failed Soviet socialistic experiment. It gives the Federal Government absolute control over health care in America….Say "no'' to socialism. Say "no'' to totalitarianism. Say ‘no’ to this bill."

The House passed the Senate health care bill by a vote of 219-212. 219 Democrats -- including all of the most progressive members -- voted "yea." All 178 Republicans and 34 Democrats voted "nay." As a result, the House passed legislation making major changes to the national health care system, including expanding health coverage to uninsured Americans -- thereby enabling the president to sign it into law.